社區大學SARS資訊網•sars.bamboo.hc.edu.tw
本文清列香港中文大學、新加坡政府與美國CDC的說法，
前面並由彭明輝做導讀
讀者可以從這些文件清楚知道 SARS 是怎麼傳染的，
並走出恐懼，認真開始練習防護的辦法
（很簡單，只是戴口罩、勤洗手）
5/19大修，5/26更新
關於SARS的傳播方式，最信實、可靠而且嚴謹的說法 ，有可能是香港中文大學的網頁。在他們的 FAQ 裡面，關於SARS的病徵，是Lancet 期刊論文用 1,425 個病患的資料取統計出來的。統計資料清楚顯示：SARS 病患中只有 94％ 有高燒，72.3％有流行性感冒的類似症狀。除此之外，香港中文大學的威爾斯親王醫院一直和 WHO 緊密地合作著，而且從慘痛的人命教訓中積極學習，也發表過好幾篇全世界最早的 SARS 專業學術期刊。
新加坡政府的說法也很實在，不去說未經證實的「理論上有可能」 ，也不會像美國CDC那樣玩弄政治性的措辭，直接根據過去的案例說話。
讀者只要認真把握香港中文大學和新加坡政府的說法，就可以清楚掌握到防範SARS的重點。有重點才能作得「滴水不透」。
美國疾病管制局（CDC）的說法最狡猾 ，不直率但是最安全。所以，我把它的說法放到最後面。當你（妳）看CDC的說法時記得一件事：這裡頭有些是政客的措辭，為的是充分保護自己的政治前途。
CDC 先是說出了目前已知的SARS主要傳染途徑（直接吸入患者口鼻飛沫，或接觸有毒液滴後再碰觸眼、鼻、口），接著又為了保護自己（政治考量）而最後一款（第三款）加上一條讓人毛骨悚然的「或許也可以通過氣流或目前未知的方式傳播到更寬廣的範圍」。但是，除了淘大社區案以及威爾斯親王醫院的噴霧治療外，我想不起任何有關最後這條但書的具體案例。
根據英文的習慣，最重要而最確定的事例寫在前面，最不重要或最不確定的事寫在段落最後面。CDC的措辭既清楚表現出最後一款但書是最不重要或/且最不確定的事例，因此算不上威脅與誤導讀者，但是卻又充分保護了自己。CDC的局長在記者會上曾經表示過：這一款是為了充分涵蓋所有的可能性，而不是因為有具體證據顯示必須要特別警告美國民眾。
目前存在的證據顯示：絕大部分的傳播都是藉由患者的口鼻分泌物。接觸到被污染的物件或患者的體液（然後再碰觸眼、鼻、口）也有可能是另一個傳播途徑。淘大花園社區的傳播模式算是特殊（special）的環境污染方式。但是（在這個案例中）香港衛生署的調查報告也已經指出空氣傳染（病毒或含有病毒的液滴在空氣中自由漂浮並擴散而傳染的方式）是極不可能的傳播模式。
雖然專家還無法完全確定SARS病患的傳染模式和尖峰傳染時刻，但是根據已經收集到的臨床觀察，很可能SARS病患傳染力最高的時候是在他已發展出症狀的時候，也就是當他發燒，尤其是咳嗽的階段。最容易被傳染的場合是：在群眾密集的密閉空間中，長久暴露於與以發病之SARS病患的接觸。這可以解釋為什麼醫護人員的被感染率最高。因此，早期的診斷與治療之所以重要，不僅僅只是為了較好的療效，也是為了更有效地控制SARS的傳播。
The available evidence suggests the mode of transmission is most consistent with droplet spread through respiratory secretions. Contact with contaminated surfaces and other body fluids may also be another route of spread. (The unusual spread in Amoy Garden could be related to special associated environmental hazardous factors - the Main findings and report on the Investigation has been released by the Department of Health on April 17. It was also concluded that Airborne spread is most unlikely). http://www.info.gov.hk/dh/ap.htm
Although experts are still not sure about the exact mode and peak time of spread, from the accumulated clinical observations, it is likely that the Infectivity of SARS is highest when the affected person develops symptoms i.e. fever and particularly when coughing. Crowded enclosed space together with prolonged exposure to the affected symptomatic patient gives the highest risk of being infected (explaining the higher infection rate of medical and health care personnel). Early diagnosis and treatment is most important therefore, not only for the better results of treatment but also for containment of the spread of the disease.
SARS是藉由近距離接觸患者而傳染。它的傳染途徑是：當患者咳嗽或打噴嚏時把口鼻飛沫傳播到附近去。
近距離意味著照顧病患或與病患同住，或直接接觸到患者的口鼻分泌物（當他咳嗽或打噴嚏時）或體液（身體的黏液或唾液）。
沒有任何證據顯示SARS可以藉由中央空調傳染。SARS病毒似乎也不會在空氣中漂浮很久，否則被傳染的人以定會比現在所知更多。
How SARS Spreads
|
Close Contact with infected |
Not Airborne |
No evidence of Air Conditioning |
SARS is spread through close contact with an infected person. It is transmitted through droplets spread when an infected person coughs or sneezes, and the droplets are spread to a nearby contact.
Close contact means having cared for, lived with, or had direct contact with respiratory secretions (coughing and sneezing) or body fluids (mucus, saliva) of a person with SARS.
There is no evidence at present that SARS can be spread through the central air-conditioning system. The SARS virus also does not seem to be airborne (float in the air for long periods), otherwise many people would have caught it by now.
答：當你近距離接觸（close contact）SARS的感染者後就有可能被感染。根據到目前為止的證據，新加坡被感染者主要是醫院裡照顧SARS病患的新進醫護人員、病患家屬，以及其它與病患近距離接觸的人。
答：根據WHO的說法，「近距離」意味著下列情況之一：
照顧病患，或
與病患同住，或
（不是醫護人員也不是病患家屬，但是）直接接觸到（吸入或沾黏到手上然後去碰觸眼、鼻、口）病患的口鼻分泌物或體液（血液、糞便、尿液等）。
Q：Is SARS infectious?
A：The infection can spread to persons who have had close contact with an infected person. Based on evidence so far, persons who have been infected in Singapore were healthcare workers who had attended to the patients when they were first admitted to the hospital, and family members and other close contacts of the patients. Some infected persons are good "hosts" to the virus and can be very infectious. Scientists think the virus is most likely to be a strain of coronavirus not previously known.
Q：What does close contact mean?
A：According to WHO, close contact means:
having cared for,
having lived with or
having had direct contact with respiratory secretions and body fluids of a person with SARS
SARS的主要傳播方式是藉由人與人之間的近距離接觸。大多數SARS的新患者都是SARS患者的照顧者（醫護人員）或同住者（家屬），或是接觸了SARS患者的傳染性物質（例如呼吸道分泌物）的人。SARS的可能傳播方式包括：接觸到 沾有傳染性液滴（即：SARS病患體液或含病毒之水滴）的他人皮膚或物件，然後再碰觸到你自己的眼睛、鼻子、嘴巴三個部位之一。
這種事情所以會發生的可能原因是：SARS病患在咳嗽或打噴嚏時把口鼻分泌物噴到自己或旁人身上，或者噴到周圍物件表面。
另一種可能性是：SARS也有可能被氣流或目前仍不知道的方式帶到較寬廣的範圍。
How is
SARS spread?
The primary way that SARS appears to spread is by close person-to-person
contact. Potential ways in which SARS can be spread include touching the skin of
other people or objects that are contaminated with infectious droplets and then
touching your eye(s), nose, or mouth. This can happen when someone who is sick
with SARS coughs or sneezes droplets onto themselves, other people, or nearby
surfaces. It also is possible that SARS can be spread more broadly through the
air or by other ways that are currently not known.
許多常識都有助於你用來防範SARS和其它許多傳染性疾病。最重要的是經常用肥皂洗手，或者使用酒精擦拭消毒你的手。此外，你應該要避免用不乾淨的手去碰觸到你自己的眼睛、鼻子、嘴巴三個部位。還有，你應該要勸身邊的人「咳嗽或打噴嚏時要用衛生紙或手帕遮住鼻子和嘴巴」。
How can
I protect myself against SARS? NEW!
There are some common-sense measures that you can take to prevent the spread of
SARS that apply to many infectious diseases. The most important is frequent hand
washing with soap and water or use of alcohol-based hand rubs (See
Guideline for Hand Hygiene in
Health-Care Settings). In addition, you should avoid touching your eyes,
nose, and mouth with unclean hands and encourage people around you to cover
their nose and mouth with a tissue when coughing or sneezing.
社區大學SARS資訊網
資訊提供：彭明輝
(社區大學全國促進會理事、清華大學動力機械系教授)
網站維護製作：新竹市青草湖社區大學、新竹市風城社區大學、新竹市香山社區大學
公共版權、社區服務，歡迎下載、複製、轉載、連結：http://sars.bamboo.hc.edu.tw/
歡迎批評與指正：mhperng@mx.nthu.edu.tw
(彭明輝)
